Comparison of Post-Thyroidectomy Scar Outcomes Using Polydioxanone vs Polyglactin 910 Sutures in the Subdermal Layer

Introduction: Incidences of thyroid tumors are increasing followed by the rising of thyroidectomy and incidence of surgical scar. Precise subdermal approximation with an absorbable suture material that provides prolonged support to the wound has been found to reduce scar formation. Objectives: To compare post-thyroidectomy scar outcomes between Polydioxanone (PDS) and Polyglactin 910 (Vicryl) in subdermal sutures. Methods: A total of 32 participants undergoing thyroidectomy were divided into 2 groups with 16 patients in each group at Thammasat University Hospital from February 10th to November 30th, 2019. In Group1, Polydioxanone 4-0 was used for subdermal layer suture, whereas, in Group2, Polyglactin 910 4-0 was used. Nylon 5-0 was used for epidermal suture in both groups. Post-surgical scar outcomes were evaluated using the Vancouver Scar Scale (VSS) at 2 weeks, 4 weeks, and 12 weeks postoperatively. Patient satisfaction was evaluated by The Patient and Observer Scar Assessment Scale (POSAS) at 12 weeks postoperatively. Results: Scar quality comparison showed no statistically significant difference in VSS between the two groups (p = 0.423, 0.677, 0.478) using the independent t-test. However, a subunit analysis of VSS revealed a significant difference in the vascularity parameter (p = 0.046) at the 2-week follow-up. The patient satisfaction evaluation according to POSAS of the group with Polydioxanone was higher than Polyglactin910, but without significant difference (p value = 0.121). Conclusion: Using Polydioxanone and Polyglactin 910 in the subdermal layer suture resulted in similar appearing scars at 2 weeks, 4 weeks, and 12 weeks post thyroidectomy. Therefore, surgeons may consider choosing the type of suture according to their preference and familiarity with the material in conjunction with using meticulous techniques to prevent scar formation.